2017 年第 10 期 第 12 卷

以病例为基础的教学法联合循证医学教学法在心脏外科教学中的初步应用

Application of case-based learning combined with evidence-based medicine teaching method in cardiac surgery education

作者：贾一新孟旭李岩焦玉清韩薇

英文作者：Jia Yixin Meng Xu Li Yan Jiao Yuqing Han Wei

单位：100029首都医科大学附属北京安贞医院心脏外科

英文单位：Department of Cardiac Surgery Beijing Anzhen Hospital Capital Medical University Beijing 100029 China

关键词：心脏外科；以病例为基础的教学法；循证医学教学法；测量问卷

英文关键词：Cardiacsurgery；Case-basedlearning；Evidence-basedmedicine；Surveyquestionnaire

• 摘要：

• 目的 探讨以病例为基础的教学法（CBL）联合循证医学教学法在心脏外科教学中的效果。方法 将2010级至2013级首都医科大学临床医学专业的142名本科生采用随机区组设计方法分为观察组（76人）和对照组（66人）。观察组采用CBL联合循证医学教学法，对照组采用传统的以授课为基础的教学法。教学活动前后进行中文版批判性思维能力测量问卷调查，教学结束时进行随堂测试考核理论知识。比较2组问卷调查和随堂测试结果。结果 问卷调查结果显示，教学结束时观察组具有正性批判性思维能力，总分和分析能力、系统化能力、批判性思维的自信心、求知欲得分均高于对照组［（312±30）分比（256±30）分、（48±6）分比（39±7）分、（48±7）分比（37±7）分、（52±6）分比（35±7）分、（47±5）分比（38±7）分］，差异均有统计学意义（均P＜0.05）。随堂测试结果显示，观察组总成绩和病例分析题成绩均高于对照组［85.5（82.0，88.5）分比78.0（68.5，82.0）分、45.5（40.0，50.0）分比35.0（31.5，38.0）分］，差异均有统计学意义（均P＜0.05）。结论 CBL联合循证医学教学法能够提高学生的学习主动性，有利于知识的掌握和临床分析能力、批判性思维能力的培养，有利于提高心脏外科临床教学质量。

• Objective To evaluate the application value of case-based learning(CBL) combined with evidence-based medicine(EBM) teaching method in cardiac surgery education. Methods A total of 142 undergraduates majoring in clinical medicine（grade 2010-2013） in Capital Medical University were randomly divided into observation group（76 cases） and control group（66 cases）. The observation group participated in CBL＋EBM cardiac surgery education; the control group received traditional teaching lessons. The Critical Thinking Disposition Inventory(CTDI-CV) questionnaire was conducted and a classroom test was performed in both groups after classes. Results The total score of CTDI-CV and scores of analyzing ability, systematic ability, self-confidence and thirst for knowledge in observation group were significantly higher than those in control group［（312±30）points vs （256±30）points, （48±6）points vs （39±7）points, （48±7）points vs （37±7）points, （52±6）points vs （35±7）points, （47±5）points vs （38±7）points］（P＜0.05）. The total test score and case analysis score in observation group were significantly higher than those in control group［85.5（82.0，88.5）points vs 78.0（68.5，82.0）points, 45.5（40.0，50.0）points vs 35.0（31.5，38.0）points］（P＜0.05）. Conclusions Combined education based on CBL and EBM can improve learning initiative, mastery of knowledge, critical thinking and practical analyzing abilities in students, which may enhance the quality of cardiac surgery education.